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HomeMy WebLinkAboutBP25-247 _ eq _ N N a N N r, s �a v rE gi _ ( 1 ['r yyam' O `a '[ e�s0'� 3 (� •�..�. c c z - w g -o Q � �00 ,� � 00 Ln rT • W Tr N Q as0oo tea, Fr.l + yi ° V a aoC r"'+ d� V © a a WA E a V v O o a V► Z � � v dci Q � � � o � v � N H F Q F v ca wo0 . �} w A Z O 61 x O >* .Iq w z x 0gg50 a - BUII.DING DEPARTMENT D ; DEC ' 9 VILLAGE OF RYE BROOK �5 938 KING STRI Ei, RYE ftooK,NY 10573 VILLAGE OF RYE BROOK `',4)939-0668 BUILDING DEPARTMENT ww Lnebrooknyxov INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Dale: t 14 Z f Application Fee:$ - `tlApproval Signature: Permit Fees: $ -b - v6 Disapproved: Other: S [ V 1� ####**�*�*,►*#��x**��*����::r*�r*��,r*�,**r*�***��***«��*«*�*�:�*�+r****,1�l�-*,r*,�,�*****ate. *****,e*•�'s,►���rtt**�** Application dated: is hereby made w the Building Inspector ofthe Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. lob Address: 1 L l = 14-IkC�.S BL: Zone: 2. Proposed Improvement.(Describe in detail): L-4---�-� !�J 1j:-M1�jt 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: 11!�: Yes: If yes,indicate: TIER 1: TIER iI: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existin automatic fire suppression system(Fire Sprinkler,ANSL System,FM-2t)0 System,Type 1 Hood,etc...) :No: Yes: (if yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fam.,con um,etc...)Prior to Construction: ^1FLd'v '4 After Construction: l 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property`t er:� Address: a=3-1= JG1 h1c'S Lm Ise a 15 zza Phone# Cell# �-11"7-qrZ email: A-&Eg m e- IL'2 • 8. Applicant: :5F-r Q\V --mot2 Address: Phone# Cell# email: 9. Architect:! �i- TS+-A !Address: !�2 15�m J A.-fr, 2L -1L E,l l`tllTl�''Z? Phone# Cell#q/*- 1-55-6116! email: 10. Engineer: Address: Phone#— Cell# email: 11. General Contractor.RAe—" [ TJ7 dr71 t i[ Address: tI 7 ;I=J JC-:?P ft�ICT G 12,n E,RIEO&22 NY Phone# Cell email. 21j^�, �fLIIL 12. Estimated cost of construction $ ",C�I oo�) c�3 A►c t 1-� (NOTE:The estimated cost shall include all labor.material.scaffolding,rmed equipment.professional fees.and material and labor which may be donated gratis.1 13. Job Timetable: Start: Finish: (I) 6/1/2024 BUILDING- RTMENT VILLAGE OF RYE OROOK 938 KING STREET RYE BROOK,NY 10573 (91,4)939-0668 www.rvebrookU.2ov AFFIDAVIT OF COMPLIANCE VILLAGE CODE §21 b • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: residing at, being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; , Rye Brook,NY. (Joh Address) Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (5i«n: cc�tl'ro�crri [)� t�rf� l (Print Name of Property 0%%neoS1) Sworn to before me this w (Notary PU1111e) SHARI MELILLO Notary iPUblic,State of New York No.OIME6160063 Qualified in Westchester County Commission Expires January 29,20D17 (2) 6n t2oza This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the for the legal owner and is duly authorized to make and file this application. (indicate architect contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed, or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications, as well as in accordance with the New York State Uniform Fire Prevention& Building Code, the Code of the Village of Rye Brook and all other applicable laws, ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this Swom to before me this day of c P � , 20 � day of , 20 Signature of 1voperty Owner Signature of Applicant ame of property Owner Print Name of Applicant No Public SHARI MELILLO Notary Public Notary Public,State of New York No.OIME6160063 Qualified in Westchester county Commission Expires January 29,20_ (4) 6/1/2024